Archived: Insignia Healthcare (Norwich)

Insignia Healthcare (Norwich) was registered by the Care Quality Commission (CQC) on 3 December 2015. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led. This was the first comprehensive inspection since the provider registered with CQC to provide personal care to people. As such, they had not yet received a CQC rating.

Insignia Healthcare (Norwich) is a domiciliary care agency which provides personal care to people with a variety of needs including older people, people living with dementia, younger adults, people with a learning disability, physical disability and people who need support with their mental health. The agency's office is located in St. Andrew, Norwich. At the time of our inspection, the service was providing personal care to 19 people.

There was a registered manager in post who was also the provider of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. In this report when we speak about both the company and the registered manager, we refer to them as being, 'the registered persons'. The provider had recently appointed a manager with the intention they become registered and manage the service on a day to day basis. They had also submitted an application to register with the Care Quality Commission (CQC).

People and healthcare assistants spoke highly of the care co-ordinators and the company. People expressed satisfaction with the service they received. However, the provider had found that quality assurance systems were not always being used to ensure accurate records were maintained and to drive improvements. The provider had implemented computer software 10 days prior to the inspection to improve this, however we will need to assess how this improvement has been embedded and sustained at our next inspection. We found no evidence that the lack of audits and gaps in records had impacted on the quality of service people received.

Risks to people's wellbeing and safety had been effectively mitigated. We found individual risks had been assessed and recorded in people's care plans. Examples of risk assessments relating to personal care included moving and handling, nutrition, falls and continence support. Health care needs were met well, with prompt referrals made when necessary.

People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.

Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. This contributed to protecting people from the employment of staff who were not suitable to work in care. There were enough staff to protect people's health, safety and welfare in a consistent and reliable way.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.

The management team and staff had an understanding of the Mental Capacity Act 2005 and consent to care and treatment.

People chose their own food and drink and were supported to maintain a balanced diet where this was required.

People said staff were caring and kind and their individual needs were met. Staff knew people well and demonstrated they had a good understanding of people's needs and choices. Staff treated people with kindness, compassion and respect. Staff recognised people's right to privacy and promoted their dignity.

We looked at care records and found good standards of person centred care planning. Care plans represented people's needs, preferences and life stories to enable staff to fully understand people's needs and wishes. The good level of person centred care meant people led independent lifestyles, maintained relationships and were fully involved in the local community.

There was a complaints policy and information regarding the complaints procedure was available. There was one complaint in the past 12 months. Records demonstrated this was listened to, investigated in a timely manner, and used to improve the service. Feedback from people was positive regarding the standard of care they received.

Staff felt supported by management, they said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service.

The provider had developed an open and positive culture, which focused on improving the experience for people and staff. The provider welcomed suggestions for improvement and acted on these.